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January 1961

Clinical Medicine and the Psychotic Patient

Arch Intern Med. 1961;107(1):144. doi:10.1001/archinte.1961.03620010148025

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The authors believe that there are certain special characteristics of medical practice in a neuropsychiatric hospital. Some disorders are peculiar to the psychotic patient, such as the exhaustion syndrome, and megacolon, and some disorders are rarely seen in the psychotic patient, such as acute bronchial asthma, hay fever, and rheumatoid arthritis. Another distinctive feature is that many patients who are developing or suffering from serious physical illnesses make no complaints or distort or disguise their complaints so that the physician may be misled or must pay special attention to unusual and somewhat atypical forms of behavior. Interviewing the patient to get a clear description of the complaints may involve a physician in the psychotic thinking of the patient. The history of familial diseases is apt to be unreliable when obtained from the patient, as is his own past medical and surgical history. Furthermore, the patient may need special handling during

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